Color doppler sonography and scintigraphy in the assessment of varicoceles

Hakkı PERK, Mustafa YILDIZ, M. Burak HOŞCAN, Alim KOŞAR, Ahmet YEŞİLDAĞ, T. Ahmet SEREL

Özet

Varikoselin fertil hastalarda renkli Dopier ultrasonografl, kan havuzu sintigrafısi ve fizik muayene sonuçlarını karşılaştırmak. Method: Çalışmamıza renkli Dopler ultrasonografl ile varikosel saptanan 30 infertil hasta dahil edildi. Renkli Dopler ultrasonografinin sonuçlan, fizik muayene ve skrotal kan havuzu sintigrafısi bulguları ile karşılaştırıldı. Sonuçlar: Fizik muayene ile 30 hastanın, 20'sinde değişik derecelerde sol varikosel, 3'ünde de bilateral varikosel bulundu. Renkli Dopler ultrasonografl ile 21 hastada sol varikosel, 9 hastada da bilateral varikosel saptandı. Aynı hastaların sintigrafık incelemesi sonucu 22'sinde sol varikosel, S'inde ise bilateral varikosel bulundu. Renkli Dopler ultrasonograftde varikosel derecesi ile retrograd akım arasında ilişki saptanmadı (r=0.174, p=0.3SS). Sintigrafık inceleme gözönüne alındığında, varikosel derecesi ile venöz tutulum arasında anlamlı ilişki vardı (r=0.6S7, p=O.OOJ). Yorum: Renkli Dopler ultrasonografl ve sintigrafı varikosel teşhisinde basit, kullanışlı, noninvazifve geçerli teşhis yöntemleridir. Aynca sintigrafık inceleme, varikosel derecesini de yüksek oranda belirleyebilmektedir, radyasyon ve intravenöz enjeksiyon gerektirmez.

Abstract

Purpose: The aim of this study was to compare color Doppler ultrasonography, scrotal blood pool scintigraphy ami physical examination in the diagnosis o f in fertile patients with varicocele. Methods: We evaluated 30 infertile patients with varicocele, who were determined by color Doppler ultrasonography (CDUS).The results of CDUS were compared with those of physical examination and scrotal blood pool scintigraphy. Results: Twenty-one patients were diagnosed as left varicocele and 9 patients had bilateral varicocele by CDUS. Of the 30 patients, 20 were found to have left varicocele of varying severity, and 3 of them were also associated with bilateral varicocele by physical examination. Meanwhile, of the same patients examined by scintigraphy, 22 had left varicocele and S had bilateral varicocele. There was no correlation between varicocele grade and retrograde flow with CDUS (r=0.174, p=0.358). When considering scintigraphic evaluation, there was a good correlation between the grade of varicocele and venous up-take (r = 0.657, p=0.001). In only 4 of 7 subclinic cases, CDUS examination showed evidence of varicocele before being diagnosed as varicocele by scintigraphy Conclusion: CDUS and Scintigraphy techniques may provide a simple, useful and noninvasive modality for the accurate diagnosis of varicoceles. Additionally, scintigraphic evalaluation is highly representative of the grade of varicocele. On the other hand, CDUS does not involve radiation and intravenous infection and is also cheaper than blood pool scintigraphy, and can be performed in a short time.